<style type="text/css">
<!--
.td_banner {background:#dfdfdd;	height: 24px; line-height:24px; color:#5B5B4D;}

.pad10{padding:10px 0; color:#5B5B4D;font-size:12px;}
.leftTab{width:150px; float:left;}
.sub_border{border-bottom:#dfdfdd 1px solid; border-top:#dfdfdd 1px solid; height:20px; text-align:right; padding:8px 0;}
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.click_here{color:#003399;text-decoration:underline;}
.click_here:hover{text-decoration:none;}
</style>

<div class="page-head">
    <h3><?php echo Mage::helper('contactus')->__('Paint Runner Competition') ?></h3>
</div>
<div id="messages_product_view"><?php echo $this->getMessagesBlock()->getGroupedHtml() ?></div>

<div class="padder">
	<form action="<?php echo $this->getFormAction(); ?>" id="contactForm" method="post">
		<div class="td_banner"><strong>COMPETITION ENTRY FORM</strong></div>
		<div class="pad10">Simply answer the competition question and enter your details in all the relevant fields below!   Click SUBMIT to send your answer.  Selkin will then send you an email to the address you have just provided. All you need to do   now is listen out for the details of the winner which will be announced LIVE on IDEAL WORLD.</div>
		<div class="pad10"><img src="<?php echo $this->getSkinUrl('images/content22.jpg');?>" /></div>

		<div class="td_banner"><strong>YOUR ANSWER TO THE PRIZE DRAW ENTRY QUESTION</strong></div>
		<div class="pad10">
			What is the maximum coverage you can achieve with a loaded Paint Runner? is it...<br />
			<div class="leftTab"></div>
			A)<input name="manu" value="1m2" type="radio"/>1m<sup>2</sup>&nbsp;&nbsp;&nbsp;
			B)<input name="manu" value="10m2" type="radio"/>10m<sup>2</sup>&nbsp;&nbsp;&nbsp;
			C)<input name="manu" value="17m2" type="radio"/>17m<sup>2</sup>&nbsp;&nbsp;&nbsp;
		</div>
		
		<div class="td_banner"><strong>WHERE DID YOU HEAR ABOUT THE COMPETITION?</strong></div>
		<div class="pad10">
			<div class="leftTab">SELECT:</div>
			<select name="hearabout" class="required-entry">
				<option value="">Please choose...</option>
				<option value="Selkin website">Selkin website</option>
				<option value="Ideal Shopping Channel">Ideal Shopping Channel</option>
				<option value="Other">Other</option>
			</select>
		</div>
		<div class="td_banner"><strong>YOUR NAME</strong></div>
		<div class="pad10">
			<div class="leftTab">TITLE:</div>
			<input name="title" value="Mr" type="radio" />Mr
			<input name="title" value="Mrs" type="radio" />Mrs
			<input name="title" value="Miss" type="radio" />Miss
			<input name="title" value="Ms" type="radio" />Ms
		</div>
		
		<div class="pad10">
			<div class="leftTab ">	 SURNAME</div>
			<input name="surname" value="" type="text" class="required-entry input-text"/>
			<br />
			<div class="leftTab">	  FORENAME</div>
			<input name="forename" value="" type="text" class="required-entry input-text"/>
		</div>
		
		<div class="td_banner"><strong>CONTACT DETAILS</strong></div>	
		<div class="pad10">
			<div class="leftTab">	<strong>TEL NO. </strong> </div>
			<input name="tel" value="" type="text" class="required-entry input-text"/>
			<br />
			<div class="leftTab">	<strong>EMAIL </strong> *</div>
			<input name="email" value="" type="text" class="required-entry input-text validate-email"/>
		</div> 
		
		<div class="pad10">
			<input name="check1" value="yes" type="checkbox" />
			Thanks for entering our great competition. Selkin have been selling  innovative and interesting products since 1952. We don't need to know  all your personal details but please tick this box so we can send you  exciting news about our new and interesting products as we launch them.
		</div>
		<div class="pad10">
			<input name="check2" value="yes" type="checkbox"  class="required-entry"/>
			Please tick this box to confirm you agree to our Terms &amp; Conditions.<a href="<?php echo $this->getUrl()?>competition-terms-conditions" target="_blank" class="click_here">Click here</a> to read our Terms &amp; Conditions.
		</div>  
		
		<div class="button-set">
			<input name="comp_cat" value="2" type="hidden" />
			<input type="image" src="<?php echo $this->getSkinUrl('images/btn_submit.gif');?>" alt="<?php echo $this->__('Submit') ?>"/>
		</div>

	</form>
	<script type="text/javascript">
	    var contactForm = new VarienForm('contactForm', true);
	</script>
</div>